Migraine Headaches

What are migraine headaches?

This throbbing type of headache is distinguished by the fact that symptoms other than pain occur with the headache. Nausea and vomiting, lightheadedness, sensitivity to light (photophobia), and other visual disturbances are common migraine symptoms.

Migraines are also unique in that they have distinct phases. Not all individuals experience each phase, however. The phases of a migraine headache may include:

Premonition phase. A change in mood or behavior that may occur hours or days before the headache.

Aura phase. A group of visual, sensory, or motor symptoms that immediately precede the headache. Examples include hallucinations, numbness, changes in speech, and muscle weakness.

Headache phase. Period during the actual headache. Throbbing pain occurs on one or both sides of the head. Sensitivity to light and motion is common, as are depression, fatigue, and anxiety.

Headache resolution phase. Pain lessens during this phase, but may be replaced with fatigue, irritability, and difficulty concentrating. Some individuals feel refreshed after an attack, while others do not.

What are the most common types of migraines?

Migraine classification helps to guide treatment. The categories below help to narrow down the classification process.

Migraine without aura. This more common type of migraine does not include an aura phase (symptoms that come just before the headache).

Migraine with aura. Fewer migraine sufferers have this type of migraine, which is preceded by aura symptoms, such as a flashing light or zigzag lines. These symptoms usually appear within 30 minutes before an attack.

How are migraines diagnosed?

Migraine headaches are diagnosed primarily based on reported symptoms, but a thorough medical exam, which may include other tests or procedures, may be used to rule out underlying diseases or conditions.

Tracking and sharing information about your headache with your doctor helps with the process of making an accurate diagnosis. Consider writing down the following information to take to your medical appointment:

Time of day when your headaches occur

Specific location of your headaches

How your headaches feel

How long your headaches last

Any changes in behavior or personality

Effect of changes in position or activities on the headache

Effect of headaches on sleep patterns

Information about stress in your life

Information about any head trauma

Diagnostic tests that may be used to confirm a migraine diagnosis include computerized tomography (CT) scans, magnetic resonance imagining (MRI), and spinal tap (lumbar puncture). These tests help to rule out other problems, such as tumors, infection, or blood vessel irregularities, that may cause migraine-like symptoms.

What is the treatment for migraines?

Specific treatment for headaches will be determined by your doctor based on:

Your age, overall health, and medical history

Type of migraine

Severity and frequency of the migraine

Your tolerance for specific medications, procedures, or therapies

Your opinion or preference

The ultimate goal of treatment is to stop migraines from occurring. Adequate management depends on the accurate identification of the type of headache and may include:

Avoiding known triggers, such as certain foods and beverages, lack of sleep, and fasting

Abortive medications. Medications, prescribed by your doctor, that act on specific receptors in both the brain and the blood vessels in the head, stopping a headache once it is in progress.

Rescue medications. Medications purchased over the counter, such as analgesics (pain relievers), to diminish or stop the headache.

Preventive medications. Medications prescribed by your doctor that are taken daily to suppress the onset of severe migraine headaches.

Some headaches may require immediate medical attention, including hospitalization for observation, diagnostic testing, or even surgery. Treatment is individualized, depending on the underlying condition causing the headache. Full recovery depends on the type of headache and other medical problems that may be present.